Bone Disease Program of Texas

Bone Disease Program of Texas

Description and History

The Bone Disease Program of Texas is a collaborative program between the Baylor College of Medicine and the University of Texas M.D. Anderson Cancer Center. [http://www.mdanderson.org/departments/boneprogram] It was established by an initial endowment to the two institutions by Rolanette and Charles Berdon Lawrence, Houston philanthropists. The program was established in 2002 by the two academic institutions to focus on osteoporosis and other Metabolic Bone Disease and spread of cancer to the skeleton in patients with cancer. Baylor College of Medicine's mission in this program is to develop strategies for stimulating new bone formation while The University of Texas M.D. Anderson Cancer Center is focused on bone loss in patients with cancer and the development of strategies to prevent spread of cancer (bone metastasis) into bone.

Leadership

Robert F Gagel, M.D. was the founding director of the Bone Disease Program of Texas. The current director (2007) of the Bone Disease Program of Texas is Brendan H Lee, M.D., Ph.D. A Program Advisory Committee that includes representation from both Institutions and an external advisor provides overall direction and supervision. A Development Committee has worked to encourage philanthropic support from the community.

Significance

Osteoporosis is a major health problem. Fractures of the spine or vertebral fractures occur commonly in men and women over the age of 60 and hip fracture remains a leading cause of death in elderly individuals. Repair and rehabilitation of hip fractures currently cost 15 billion dollars per year; as the "baby boomers" enter their 70s (2020) this figure is expected to reach 40-60 billion dollars per year unless effective therapies are developed. Although the introduction of several new therapies have reduced the incidence of fracture by as much as 5-10%, low bone mass leading to fractures remains a major health issue. The Surgeon General's report on osteoporosis [http://www.surgeongeneral.gov/library/bonehealth/content.html] , issued in 2004, estimates "One out of every two women over 50 will have an osteoporosis-related fracture in their lifetime, with risk of fracture increasing with age. Due primarily to the aging of the population and the previous lack of focus on bone health, the number of hip fractures in the United States could double or even triple by the year 2020."

It is this challenge that the Bone Disease Program of Texas is committed to address. Recent discoveries indicate that it is possible to build new high quality bone in older citizens. This program is committed to the development of strategies to increase bone mass and strength with the goal of preventing the epidemic of fractures expected over the next two decades.

Organization

The Bone Disease Program of Texas is defined by a contractual relationship between Baylor College of Medicine and University of Texas M.D. Anderson Cancer Center. The components include basic laboratory programs at the two institutions that include core facilities (bone density, small animal CT facilities, microCT, and bone histomorphometric facilities) that are available to members of the program from either institution. In addition, translational and clinical research programs are being developed at each institution. The program has a seminar series and monthly interdisciplinary meetings of researchers within the program.

Participants

Accomplishments

Participants in this program have made a number of important scientific discoveries. Among them are:

1. Identification of the major regulator of osteoblast differentiation and bone formation, RUNX2 (Gerard Karsenty)2. Identification of the role of fat cells and the hormone leptin in the regulation of bone formation (Patricia Ducy and Gerard Karsenty)3. Identification of Osterix, an osteoblast transcription factor that is necessary for normal bone formation and mineralization (Benoit de Crombrugghe)4. Definition of the physiologic role of the hormone calcitonin (Ana Hoff, Gilbert Cote, Robert F Gagel)5. Identification of the relationship between intravenous bisphosphonate use and osteonecrosis of the jaw (Ana Hoff and Robert F Gagel)6. Characterization of the role of TRAF6 in RANK receptor signaling and the development of inhibitors targeting this molecule to inhibit osteoclast-mediated bone resorption (Bryant Darnay)7. Characterization of the role of CTAP, a gene responsible for bone collagen modification, and definition of its role in the osteogenesis imperfecta (Roy Morello and Brendan Lee)


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